Clinical, virological, and histologic evolution of hepatitis C virus infection in liver transplant recipients.
We designed a prospective study to assess the time course and evolution of hepatitis C virus (HCV) infection in 152 patients who underwent a liver transplantation (LT) in our institution. Forty-four recipients (29%) were infected by HCV after transplantation: 40 who developed recurrent infection after LT and four who acquired infection during or after LT. No differences were found in survival actuarial rates at 1, 2, and 4 years after transplantation for patients infected by HCV vs. noninfected ones. Graft hepatitis occurred in 66% of HCV-infected recipients: 18 developed chronic active hepatitis (10 of them with intense fibrosis) and 2 developed cirrhosis during the follow-up. Infection by the HCV-1b genotype was found in 79% of the infected recipients and in 100% of those in whom histologic evolution was worst. Fourteen grafts were lost in 44 HCV-infected recipients, in comparison with 12 in 108 HCV-negative patients (P = .007), mostly because of chronic rejection. HCV infection did not affect life expectancy in the midterm follow-up for LT patients. However, it was often associated with the occurrence of early and severe graft hepatitis and with a higher incidence of graft loss due to chronic rejection.
Lumbreras
C
C
Infectious Diseases Unit, Hospital Universitario Doce de Octubre, Universidad Complutense de Madrid, Spain.
Colina
F
F
Loinaz
C
C
Domingo
M J
MJ
Fuertes
A
A
Dominguez
P
P
Gómez
R
R
Aguado
J M
JM
Lizasoain
M
M
González-Pinto
I
I
Garcia
I
I
Moreno
E
E
Noriega
A R
AR
D000328:Adult; D000368:Aged; D005260:Female; D006085:Graft Survival; D006526:Hepatitis C / Q000401:mortality / Q000473:pathology* / Q000821:virology; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence